Surgical or non-surgical periodontal treatment: factors affecting patient decision making.

BACKGROUND: This study explored which factors affected patients' decisions to pursue either surgical or non-surgical periodontal treatment. METHODS: Data were collected from 74 patients at a regularly scheduled periodontal appointment, at which each patient was told that periodontal treatment was needed, and 2 weeks following the actual treatment. The surveys assessed the patients' decisions and potential determinants of these decisions. The dental anxiety scale-revised, the state-trait anxiety inventory, and the Iowa dental control index were used to measure psychosocial factors. RESULTS: Patients who decided to have surgery did not differ from patients who decided against surgery in sociodemographic variables such as gender, age, education, and socioeconomic status, nor in their desire for control over the treatment decision. However, they had less dental fear and less general anxiety than the non-surgery patients. Although the two patient groups did not differ in their responses concerning how well the dentists had informed them about the procedure, they differed in the degree of trust and rapport with their dentists. CONCLUSIONS: The less dentally fearful and anxious patients were in general and the more they trusted their provider and felt they had good rapport, the more likely they were to accept surgical periodontal treatment. These results stress the importance of good patient-provider communication.

A survey of United States periodontists' knowledge, attitudes, and behaviors related to tobacco-cessation interventions.

BACKGROUND: Because of the clear causal relationship between smoking and periodontal disease, and the negative effect of smoking on wound healing, it is of great importance to evaluate the tobacco-cessation interventions provided by periodontal practices. The use of tobacco-cessation interventions in clinical practice can be measured by whether the practitioner uses any of the "5 A's" defined by the 2008 United States Public Health Services Clinical Practice Guideline. METHODS: Surveys were mailed to 1,000 active members of the American Academy of Periodontology. The surveys assessed the periodontists' demographic information, educational and professional background, knowledge and attitudes about tobacco cessation, and use of interventions in the daily practice of periodontics. RESULTS: Data were collected from 231 periodontists via a self-administered survey. Most (92%) believed that tobacco cessation is a responsibility of the dental profession. A pattern of declining levels of involvement was seen as the providers moved through the suggested "5 A's" for promoting tobacco cessation. Providers with formal tobacco-cessation training were more likely to perform interventions. The primary perceived barriers to providing tobacco-cessation interventions were low patient acceptance of treatment, lack of time, and lack of training. CONCLUSION: The findings of this study indicate that periodontists believe that tobacco-cessation interventions are a responsibility of the dental profession; however, because of several perceived barriers, reported rates of comprehensive tobacco interventions in periodontal practices are low.